Dr Azeem has outlined what pregnant women can expect from NHS maternity care. (Image: Humphrey Nemar/Getty)
Discovering you are pregnant can be an unforgettable moment, often bringing joy, excitement and a fair amount of uncertainty all at once. NHS maternity services are designed to guide and support you from the early weeks of pregnancy through to birth and the postnatal period, so it helps to know what care is available and when.
What to do after a positive test
After a positive pregnancy test, the next step is to get in touch with your local NHS maternity service to book your first appointment. In many areas, you can self-refer online, meaning you do not usually need to make a GP appointment first.
Even so, it is sensible to inform your GP practice that you are pregnant. This allows your medical records to be updated and gives healthcare professionals the chance to review any current medicines or existing health conditions if necessary.
If you have not already started taking folic acid, you should begin as soon as you can and continue until 12 weeks of pregnancy. Most pregnant women are also advised to take vitamin D throughout pregnancy to support their health.
Your booking appointment
Your first meeting with a midwife is known as the booking appointment and it usually happens between eight and 10 weeks of pregnancy. During this appointment, you will be able to talk through your general health, medical background and any previous pregnancies.
The midwife will also ask about your lifestyle, family medical history and any medication you are taking. You can expect blood tests, a blood pressure check and, in most cases, a urine sample, all of which help identify any health issues that may need closer monitoring during pregnancy.
For most women, pregnancy care is provided by community midwives. However, if you have an existing condition such as diabetes or high blood pressure, or if complications arise, your NHS maternity care may also include an obstetrician and other specialist healthcare teams.
Routine antenatal care
Regular antenatal appointments allow your midwife or doctor to monitor your health and your baby’s development, while giving you the opportunity to ask questions and discuss concerns.
You will usually be offered two routine ultrasounds. The first, between 11 and 14 weeks, confirms your delivery date and can include optional screening for conditions such as Down syndrome. The second scan, usually between 18 and 21 weeks, checks your baby’s development. You may be offered additional blood tests or scans.
The NHS recommends vaccines against flu, whooping cough (pertussis) and respiratory syncytial virus (RSV) at appropriate stages. Maintaining a healthy lifestyle — eating a balanced diet, remaining active, and avoiding smoking and alcohol — is important.
Pregnancy also affects emotional health. Many women experience anxiety, low mood or stress, particularly if they have experienced pregnancy loss or complications in the past. Your midwife will ask about this. If you have a history of mental health conditions, let your maternity team know.
When to seek urgent medical advice
Contact your team immediately if you experience:
- reduced or absent movements from your baby
- vaginal bleeding or leaking fluid
- severe or persistent headache
- blurred vision or flashing lights
- sudden swelling of your face, hands or feet
- severe abdominal pain
- regular contractions before 37 weeks of pregnancy
Feeling reassured about your care
You may have seen news reports about failures in maternity care at some NHS hospitals. Investigations highlighted serious problems in a small number of services and have led to significant changes, including greater emphasis on listening to women and families, improving safety, and identifying concerns earlier.
Most pregnancies and births in the NHS are safe, but it is important that you feel heard throughout your care. If you are worried that something is not right, trust your instincts and contact your maternity team.
Never worry about raising concerns. They would much rather assess you and find everything is well than miss a serious problem.
Routine ultrasounds check on a baby’s development during pregnancy (Image: Getty)
Planning your baby’s birth
You will discuss birth preferences with your midwife. Options may include a consultant-led maternity unit, a midwife-led birth centre or occasionally a home birth.
Women with higher-risk pregnancies are generally advised to give birth in an obstetric unit where specialist medical care is immediately available.
You can also discuss pain relief, including gas and air, opioids and epidural anaesthesia. Your plan should reflect your preferences, while recognising that plans sometimes need to change if complications arise.
Care after your baby is born
While you are in hospital, or shortly after a home birth, midwives will check your recovery and your baby’s health. There will be a newborn physical examination and hearing screening, and you will be offered advice on feeding.
Once you return home, your community midwife will support you during the first 10 to 14 days. Care is then transferred to your health visitor, who will monitor your baby’s development and provide advice during the early years.
You should also attend your postnatal GP check, usually six to eight weeks after giving birth. This is an opportunity to discuss your physical recovery, emotional wellbeing, contraception and ongoing health concerns.
Pregnant women are entitled to free NHS prescriptions and dental treatment during pregnancy and for 12 months after giving birth, with a maternity exemption certificate.
Supporting you
Every pregnancy is different. NHS maternity services aim to provide personalised care. By attending your appointments, following healthy lifestyle advice and seeking help promptly if you have concerns, you can give yourself and your baby the best possible start.
